incontinence

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incontinence

 [in-kon´tĭ-nens]
1. inability to control excretory functions.
2. immoderation or excess. adj., adj incon´tinent.
bowel incontinence
2. a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a state in which an individual has a change in normal bowel habits, with involuntary bowel movements.
continuous incontinence continuous urinary leakage from a source other than the urethra, such as a fistula.
fecal incontinence (incontinence of the feces) inability to control defecation; both physiologic and psychological conditions can be contributing factors. Called also encopresis and bowel incontinence. See also bowel elimination, altered. Physiologic causes include neurologic sensory and motor defects such as those occurring in stroke and spinal cord injury; pathologic conditions that impair the integrity of the sphincters, such as tumors, lacerations, fistulas, and loss of sensory innervation; altered levels of consciousness; and severe diarrhea. Psychological factors include anxiety, confusion, disorientation, depression, and despair.

There is potential for physical and psychological stress when a person is unable to control his or her bowel movements. Damage to the integrity of the skin and its breakdown into pressure ulcers is always a possibility no matter how hard caregivers might try to keep the patient clean and dry. Psychologically the person is likely to suffer from loss of self-esteem and is certain to experience some alteration in self-image. From the time of toilet training a person is expected to be able to handle the tasks of bowel elimination. An adult who for some reason is no longer able to do this is often embarrassed by and ashamed of the inability to perform this most basic of self-care activities.
Patient Care. Assessment of the problem of fecal incontinence should be extensive and thorough so that a realistic and effective plan of care can be implemented. Sometimes all that is needed is a regularly scheduled time to offer the patient a bedpan or help using a bedside commode or going to the bathroom. If diarrhea is a problem it may be that dietary intake needs changing or tube feedings are not being administered correctly. Dietary changes may also help the patient who has a stoma leading from the intestine. In cases of neurologic or neuromuscular deficit, retraining for bowel elimination is a major part of rehabilitation of the patient. Frequently, it is possible to help a patient achieve control by means of a well-planned and executed bowel training program.

Biofeedback techniques can be helpful in many cases. The person learns to maintain higher tone in the anal sphincter through use of a balloon device that provides feedback information about pressures in the rectum. With practice the person can learn better control and develop a more acute awareness of the need to defecate.
functional incontinence incontinence due to impairment of physical or cognitive functioning.
functional urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as an inability of a usually continent person to reach the toilet in time to avoid the unintentional loss of urine. See also urinary incontinence.
overflow incontinence (paradoxical incontinence) urinary incontinence due to pressure of retained urine in the bladder after the bladder has contracted to its limits; there may be a variety of presentations, including frequent or constant dribbling or symptoms similar to those of stress or urge incontinence.
reflex incontinence the urinary incontinence that accompanies detrusor hyperreflexia.
reflex urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as an involuntary loss of urine at somewhat predictable intervals, whenever a specific bladder volume is reached. See also reflex incontinence.
risk for urge urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as the state of being at risk for involuntary loss of urine associated with a sudden strong sensation of urinary urgency. See also urge urinary incontinence.
severe stress urinary incontinence severe stress incontinence as a result of incompetence of the sphincter mechanism.
stress incontinence urinary incontinence due to strain on the orifice of the bladder, as in coughing or sneezing.
stress urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as loss of urine of less than 50 ml when there is increased abdominal pressure. See also stress incontinence.
total urinary incontinence a nursing diagnosis accepted by the Seventh National Conference on the Classification of Nursing Diagnoses, defined as a state in which an individual has continuous and unpredictable loss of urine; see also urinary incontinence.
urge incontinence (urgency incontinence) urinary or fecal incontinence preceded by a sudden, uncontrollable impulse to evacuate (see also urgency). Urge incontinence of urine is a major complaint of patients with urinary tract infections and is also present in some women two or three days before onset of the menstrual period.
urge urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as the involuntary passage of urine soon after feeling a strong sense of urgency to urinate; see also urge incontinence.
urinary incontinence (incontinence of urine) loss of control of the passage of urine from the bladder; see also enuresis. It can be caused by pathologic, anatomic, or physiologic factors affecting the urinary tract, as well as by factors entirely outside it. See also urinary elimination, altered.
Patient Care. The Agency for Health Care Policy and Research (AHCPR) convened an interdisciplinary, non-Federal panel of physicians, nurses, allied health care professionals, and health care consumers that has identified and published Clinical Practice Guidelines for Urinary Incontinence in Adults. Identification and documentation of urinary incontinence can be improved with more thorough medical history taking, physical examination, and record keeping. Routine tests of lower urinary tract function should be performed for initial identification of incontinence. There are also situations that require further evaluation by qualified specialists.

The guidelines provide an informed framework for selecting appropriate behavioral, pharmacologic, and surgical treatment and supportive services that can be used to treat urinary incontinence. The panel concluded that behavioral techniques such as bladder training and pelvic muscle exercises are effective, low cost interventions that can reduce incontinence significantly in varied populations. Surgery, except in very specific cases, should be considered only after behavioral and pharmacologic interventions have been tried. The panel found evidence in the literature that treatment can improve or cure urinary incontinence in most patients. The address of the AHCPR is Agency for Health Care Policy and Research, P.O. Box 8547, Silver Spring, MD 20907. They can also be called toll free at (800) 358-9295.

in·con·ti·nence

(in-kon'ti-nens),
1. Inability to prevent the discharge of any of the excretions, especially of urine or feces.
2. Lack of restraint of the appetites, especially sexual. Compare: intemperance.
Synonym(s): incontinentia
[L. incontinentia, fr. in- neg. + con-tineo, to hold together, fr. teneo, to hold]

incontinence

(ĭn-kŏn′tə-nəns)
n.
The quality or state of being incontinent.

incontinence

 Urology The inability to control the flow of urine from the bladder. See Overflow incontinence, Paradoxic incontinence, Stool incontinence, Urge incontinence.

in·con·ti·nence

(in-kon'ti-nĕns)
1. Inability to prevent the discharge of urine or feces.
2. Lack of restraint of the appetites, especially sexual.
Synonym(s): incontinentia.
[L. incontinentia, fr. in- neg. + con-tineo, to hold together, fr. teneo, to hold]

incontinence

Loss of voluntary control of one or both of the excretory functions. Faecal incontinence is the inability to control the evacuation of the rectum. Urinary incontinence is loss of complete control over the voiding of urine. Stress incontinence features the escape of small quantities of urine on coughing, laughing or otherwise sharply increasing the pressure within the abdomen. Research published in mid-2007 of a trial of the injection of myoblasts into the rhabdosphincter and and fibroblasts submucously suggested that this method may prove important in the management of urinary stress incontinence.

Incontinence

The inability to retain urine in the bladder until a person is ready to urinate voluntarily.

in·con·ti·nence

(in-kon'ti-nĕns)
Inability to prevent the discharge of bodily excretions.
[L. incontinentia, fr. in- neg. + con-tineo, to hold together, fr. teneo, to hold]

Patient discussion about incontinence

Q. Can you treat urinary incontinence by only making exercise of circular muscles? I heard the exercise help but dont know if it is enough by itself.

A. This technique you have mentioned is called "bio-feedback" and it helps many people with urinary incontinence, by raising your awareness to muscles in your body you don't usually pay attention to, thus making you able to control them better. I do not think this is an only way to treat incontinence, however with the addition of the proper medications you can find this very helpful.

More discussions about incontinence
References in periodicals archive ?
Preservation of putative continence nerves during radical retropubic prostatectomy leads to more rapid return of urinary continence. Urology 1998; 51: 960-7.
The primary aim of this study was to investigate the impact of menopausal status on urinary continence following ASC without an anti-incontinence procedure in continent women.
The follow-up activities included receiving reports from the patients about urinary continence and a direct inquiry concerning ability to control urine plus a midstream urine microscopic examination.
That %70 women with urinary incontinence and %40 of women with urinary continence had flat foot.
Intravaginal electrical stimulation increases urinary continence and improves SUI symptoms; percutaneous electrical stimulation also improves SUI symptoms and likely improves QOL measures (SOR: A, systematic review).
This largely benefits in thwarting pregnancy woes, helping to maintain urinary continence, and stabilizing the pelvis and lower back.
* Urinary continence - assessment, currently available treatment, and adjunct use of catheters and collecting devices.
Most gram-negative bacteria were susceptible to amikacin and third-generation cephalosporins Frequency of UTI was calculated in different modes of voiding urine and it was found that out of 37 patients with UTI 20 (54.05%) had indwelling catheter , 15 (40.5%) were using clean intermittent catheterization (IC), 1 (2.7% )was using crede maneuver to void urine, and 1 (2.7%) had suprapubic cystostomy, while no patients with reflex voiding and urinary continence had UTI, showing that, UTI was more frequent in SCI patients using catheterization as mode of voiding but more in indwelling catheterization as compared to IC, proving safety of use of IC in neurogenic bladder
The MDS 3.0 has new definitions for coding urinary continence that include the outcome of toileting programs by counting episodes of continent voiding or episodes of incontinence during the look-back period as well as the coding of the current toileting programs in item H0200-C.